Impact of myocardial injury on cardiovascular complications in hospitalized patients with COVID-19: insights from Latin America.
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Cárdenas-Marín Paula Andrea, Cordoba-Melo Brayan Daniel, Carrillo-Gómez Diana Cristina, León-Giraldo Hoover, Mendoza Iván, Flórez Noel, Larrea Gómez Ricardo Enrique, Mercedes Jessica Mirella, Herrera Cesar J, Lugo-Peña Julián, Cárdenas-Aldaz Liliana Patricia, Rossel Victor, Ramírez Ramírez Ricardo, Fernández Hugo Fernando, Retana Andrés Ulate, Sierra-Lara Martinez J Daniel, Figueiredo Estevão Lanna, Yabar Galindo Wilbert German, Quintana Da Silva Miguel Angel, Romero Alexander, Silva Paula, Alvarado Armando, Valencia Andrea, Gomez-Mesa Juan Esteban
Аннотация
METHODOLOGY: Retrospective cross-sectional study of hospitalized COVID-19 patients diagnosed between May 01, 2020, and June 30, 2021, from the database of the Registro Latinoamericano de Enfermedad Cardiovascular y COVID-19 (CARDIO COVID 19-20) with a troponin value recorded during hospitalization. A descriptive analysis of sociodemographic and clinical characteristics was performed. Bivariate analysis was conducted according to the presence or absence of myocardial injury. Survival analysis was made using Kaplan-Meier curves, by the presence of myocardial injury. A multivariate Poisson regression model was performed to determine factors associated with mortality. Statistical analyses were performed using the RStudio V.1.4.1717 package.
RESULTS: A total of 2,134 patients were included, 64.2% were male, and 911 patients had myocardial injury. The median age of the total population was 61 years. Individuals with myocardial injury had a higher prevalence of hypertension, diabetes, and dyslipidemia. Survival probability was lower in this subgroup. Patients with myocardial injury had a 1.95 times higher risk of death. Age, male sex, chronic kidney disease, arrhythmias, decompensated heart failure, requirement of inotropic/vasopressor, and invasive mechanical ventilation were related to higher mortality risk in patients with myocardial injury.
CONCLUSION: Patients with COVID-19 and myocardial injury exhibit a broad spectrum of cardiac abnormalities. Myocardial injury is associated with a higher disease severity and risk of in-hospital mortality. This multicenter study uniquely represents data from 13 Latin American countries, offering regional insights into the impact of myocardial injury during the COVID-19 pandemic.